RSNA 2013: Speakers give radiologists practical advice

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RSNA 2013: Os altofalantes dão a radiologists o conselho prático

por Loren Bonner, DOTmed News Online Editor | December 02, 2013
Winston Churchill once said "If we are together, nothing is impossible. If we are divided all will fail." RSNA president Dr. Sarah Donaldson hearkened back to this quote when she drove home the message of the importance of partnership during the kick off to this year's annual RSNA meeting in Chicago.

Donaldson said that partnerships will serve radiology well during challenging times as the field comes under more scrutiny and radiologists find themselves under pressure to provide value to medicine. She said partnerships need to happen inside radiology, outside of it, and with patients.

"Change is always difficult but we must look for opportunities," said Donaldson.

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Speakers during an afternoon panel on the future of radiology also spoke about the importance of working more collaboratively.

Today, radiology is being threatened left and right. Dr. Jonathan Berlin from NorthShore University Health System in Chicago said the main threats to radiology include: declining reimbursements; the uncertain role of new payments schemes like accountable care organizations; commoditization of the field; teleradiology and national radiology corporations; and declining prestige.

But there is hope if radiologists are willing to get more involved. Dr. David Levin, a professor of radiology at Jefferson Medical College of Thomas Jefferson University in Philadelphia, said radiologists need to start acting like true consulting physicians.

"A request comes in now and we just do it — no questions asked," he said.

Radiologists will need to screen more for appropriateness as well as make themselves more available to consult with referring doctors, he said. Along that same line of thinking, he said radiology needs to do more to publicize and use ACR's appropriate use criteria, particularly in other sub-specialty journals like the Journal of Family Practice.

Like hospitals, primary care physicians are going to become increasingly influential in new payment models set forth by health care reform. Levine said radiologists will therefore need to build better bridges to primary care. In fact, he has a theory that primary care working with radiology and laboratory could probably diagnose a large majority of clinical problems without having to refer to specialists.

Like Berlin, Levin also sees teleradiology firms as a big threat to the field and he encouraged practices to "take back nights and weekends from teleradiology companies." This might mean consolidating with a larger radiology practice, a hospital or multi-specialty group in order to hire a night and emergency radiology team.

For radiologists who might already be on staff at hospitals, Dr. Rao Vijay, chair of Radiology at Jefferson Medical College of Thomas Jefferson University, said building bridges to hospital administration will also be key as administration becomes more influential in decision making.

"You want to be at the table when big decisions are made," she said.

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